A.M.A. Archives of Dermatology & Syphilology

SULZBERGER, MARION B.;BAER, RUDOLF L.;BOROTA, ALEXANDER

1952 A.M.A. Archives of Dermatology & Syphilology

doi: 10.1001/archderm.1952.01530250003001

Abstract THIS REPORT deals with systematic follow-up and examination of the skin of persons who 5 to 23 years previously had received superficial low-voltage roentgen-ray treatments. The examinations were carried out by qualified specialists in dermatology in order to ascertain what, if any, harmful sequelae or other visible late effects had occurred. The term superficial low-voltage roentgen-ray treatment is here used to designate the quality and dosage almost universally employed by skin specialists in hospitals, clinics, and private offices in the United States. In most dermatoses, the customary practice is to administer to any one area no more than 85 r weekly or 42.5 r once to twice weekly, up to a maximum total dose of about 1,400 r. These figures are based on dosages measured in air. The usual quality of irradiation used ranges from 60 to 100 kv., with half-value layers of about 0.5 to 1 mm. References 1. Miescher, G., and Böhm, C.: Roentgen Therapy of Localized Hyperhidrosis: Follow-Up of 192 Treated Patients , Schweiz. med. Wchnschr. 78:14, 1948. 2. Borak, J.; Eller, J. J., and Eller, W. D.: Roentgen Therapy for Hyperhidrosis: Observation of 122 Patients , Arch. Dermat. & Syph. 59:644 ( (June) ) 1949. 3. Shafer, J. C.; Braestrup, C. B., and Fisher, J. K.: Relation of Exit Dose and Other Dosage Factors to Roentgen Injuries , Arch. Dermat. & Syph. 59:472 ( (April) ) 1949. 4. Pipkin, L.; Lehmann, C. F., and Ressmann, A.: Treatment of Plantar Warts by Single Dose Method of Roentgen Ray , South. M. J. 42:193, 1949. 5. Montgomery, A. H.; Montgomery, R. M., and Montgomery, D. C.: Problem of Plantar Radiodermatitis , New York J. Med. 49:1664, 1949. 6. Adair, F. E.: Prophylaxis of Cancer , Bull. New York Acad. Med. 23:383, 1947. 7. Adair, F. E.: Prophylaxis of Cancer , Bull. New York Acad. Med. 24:684, 1948. 8. MacKee, G. M.: Arithmetical Computation of Roentgen Dosage , J. Cutan. Dis. 37:783, 1919 9. X-Rays and Radium in the Treatment of Diseases of the Skin , Ed. 2, Philadelphia, Lea & Febiger, 1927. 10. Before 1939 the value of the roentgen unit was such that 300 r was the skin-erythema dose with the factors generally employed at our Unit and ¼ erythema dose was considered to be 75 r unfiltered; since then the value of the roentgen unit has been officially lowered, so that ¼ erythema dose comprises 85 r at present (i. e., skin-erythema dose equals 340 r).

RATTNER, HERBERT;RODIN, H. HAROLD

1952 A.M.A. Archives of Dermatology & Syphilology

doi: 10.1001/archderm.1952.01530250020002

Abstract SOME TIME ago the director of the Hektoen Institute, which is the division of research of the Cook County Hospital in Chicago, enlisted our cooperation for a study of several new antibiotic agents. The Institute was interested particularly in a new type of penicillin, l-ephenamine penicillin G (penicillin 92).1 It has an antibacterial spectrum which in vitro parallels that of penicillin G, but which differs from it in one important respect. l-Ephenamine penicillin G is thought to have hypoallergenic properties similar to those attributed to penicillin O.2 Although there are many excellent agents available for the topical treatment of pyogenic infections of the skin, each of them has certain limitations. The better ones are the broad-spectrum antibiotics, but even among these there is none that has proved to be effective in all cases. All the antibacterial drugs on occasion may produce allergic reactions, while some References 1. Kadison, E. R.; Ishihara, S. J., and Walters, T.: A New Form of Penicillin with Anti-Allergic Properties , Am. Pract. & Digest Treat. 2:411 ( (May) ) 1951. 2. Volini, I. F.; Shlaes, W. H., and Felsenfeld, O.: Use of Penicillin O in Patients Hypersensitive to Penicillin G , J. A. M. A. 143:794 ( (July 1) ) 1950. 3. The l-ephenamine penicillin G (``compenamine'') used in this study was supplied by Commercial Solvents Corporation, New York 17. 4. Johnson, B. A.; Anker, H., and Meleney, F. L.: Bacitracin: A New Antibiotic Produced by a Member of the B. Subtilis Group , Science 102:376 ( (Oct. 12) ) 1945. 5. Waksman, S. A., and Lechevalier, H. A.: Neomycin, A New Antibiotic Active Against Streptomycin-Resistant Bacteria, Including Tuberculosis Organisms , Science 109:305 ( (March 25) ) 1949. 6. Waisbren, B. A., and Spink, W. W.: A Clinical Appraisal of Neomycin , Ann. Int. Med. 33:1099 ( (Nov.) ) 1950. 7. Swart, E. A.; Romano, A. H., and Waksman, S. A.: Fradicin, An Antifungal Agent Produced by Streptomyces Fradiae , Proc. Soc. Exper. Biol. & Med. 73:376 ( (March) ) 1950. 8. Ishihara, S. J.: Microbial Sensitivity Determinations in Small Laboratories , Laborat. Digest 14:8 ( (March) ) 1951. 9. Tests were performed by S. J. Ishihara, B. S. 10. Leifer, W., and Steiner, K.: Diiodohydroxyquinoline in Dermatologic Therapy , Arch. Dermat. & Syph. 62:46 ( (July) ) 1950. 11. Sulzberger, M. B.; Baer, R. L.; Kanof, A., and Lowenberg, C.: Methods for the Rapid Evaluation of the Beneficial and Harmful Effects of Agents Applied to the Human Skin , J. Invest. Dermat. 7:227 ( (Oct.) ) 1946.

NOMLAND, RUBEN;McKEE, ALBERT P.

1952 A.M.A. Archives of Dermatology & Syphilology

doi: 10.1001/archderm.1952.01530250027003

Abstract MILKERS' nodules in man is a virus disease of the skin acquired, in most instances, from milking cows who are infected with natural (not vaccinia or genuine) cowpox. Natural cowpox is a virus disease of the teats and the udders of milch cows and is common among dairy cows in Iowa and probably throughout the United States. Becker1 was the first to report milkers' nodules in this country; he described four cases in residents of northern Minnesota and Wisconsin. After hearing Becker's presentation, Beck2 reported three cases from Delaware, and a few years later Green3 reported one case from Louisiana. Green stated that he had seen many cases of the disease and had recognized it as an occupational disease of milkers. Hester and associates4 studied an epidemic in a dairy herd in Illinois; they saw one case of milkers' nodules and heard of several others. References 1. Becker, F. T.: Milkers' Nodules: Report of 4 Cases , J. A. M. A. 115:2140 ( (Dec. 21) ) 1940.Crossref 2. Beck, J. R.: Milkers' Nodules: A Clinical Note , Delaware M. J. 12:180 ( (Aug.) ) 1940. 3. Green, M. T.: Milkers' Nodule , New Orleans M. & S. J. 97:13 ( (July) ) 1944. 4. Hester, H. R.; Boley, L. E., and Graham, R.: Studies on Cowpox: I. An Outbreak of Natural Cowpox and Its Relation to Vaccinia , Cornell Vet. 31:360 ( (Oct.) ) 1941. 5. Hagan, W. A.: The Infectious Diseases of Domestic Animals, with Special Reference to Etiology, Diagnosis, and Biologic Therapy , Ithaca, N. Y., Comstock Publishing Company, Inc., 1943, pp. 526-529. 6. Udall, D. H.: The Practice of Veterinary Medicine , Ed. 4 (revised), Ithaca, N. Y., Author, 1943, pp. 519-523. 7. Irwin, J. G., and Howe, E. C.; Merchant, I. A. (Professor and Head of the Department of Veterinary Hygiene, Iowa State College, Ames, Iowa), and Hagan, W. A. (Dean, New York State Veterinary College, Ithaca, N. Y.): Personal communications to the authors. 8. Abente Haedo, F.: Epizootía de cowpox en un ganado lechero, producido por la inoculación accidental de un hombre, recientemente sometido a la vacunación antivariólica: Contaminación consecutiva de todo el personal del establecimiento que no había sido vacunado: Tratamiento por la fiebre artificial , Arch. urug. med. 34:252 ( (March) ) 1949. 9. Boerner, F.: An Outbreak of Cow-Pox, Introduced by Vaccination, Involving a Herd of Cattle and a Family , J. Am. Vet. M. A. 64:93 ( (Oct.) ) 1923. 10. Gray, J. S. M.: Note on an Outbreak of Cowpox Affecting Animals and Milkers at Dairy Farms , M. Officer 70:61 ( (Aug. 21) ) 1943. 11. McCloy, A.: A Case of Cow-Pox , Brit. M. J. 1:362 ( (March 8) ) 1941. 12. Schultze, W.; Seifried, O., and Schaaf, J.: Die Melkerknoten und ihre Aetiologie , Ztschr. Infektionskr., par. Krankh. u. Hyg. d. Haustiere 31:295 ( (Sept.) ) 1927. 13. Salkan, P. M.: Zur Klinik der Epidemiologie und Ätiologie der Melkerknoten , Acta dermat.-venereol. 14:342 ( (Nov.) ) 1933. 14. Stark, A. M.; Tiesenhausen, M. M.: Gozanskaja, N. M.; Skrozky, E. W., and Schtschastny, D. S.: Über die Pockenätiologie der sog. Melkerknoten , Arch. Dermat. u. Syph. 170:38, 1934.

CANIZARES, ORLANDO

1952 A.M.A. Archives of Dermatology & Syphilology

doi: 10.1001/archderm.1952.01530250039004

Abstract CHRONICITY in spite of treatment is a characteristic of all varieties of parapsoriasis. Therefore, any method of therapy which may favorably alter its chronic course is worthy of trial. In September, 1948, in the dermatologic service of the late Dr. J. Gardner Hopkins at the Veterans Administration Hospital, Bronx, N. Y., my colleagues and I saw a patient with parapsoriasis of the guttate type, who, after exposure to Florida sunlight, made a complete recovery but had a relapse on his return to New York. Because of this experience, it was thought that vitamin D2 therapy might be of value in this disease. This patient and another, successfully treated with calciferol, were presented at a meeting of the Manhattan Dermatologic Society on Feb. 8, 1949. Descriptions of these two patients and two additional ones were published in a preliminary report.1 Prior to our observations and independently of them, Barber References 1. Canizares, O.; Dwinelle, J. H., and Shatin, H.: The Treatment of Parapsoriasis with Vitamin D2 , J. Invest. Dermat. 16:121 ( (March) ) 1951. 2. Barber, H. W., and Erskine, D.: Parapsoriasis en Plaques Treated with Calciferol , Brit. J. Dermat. 61:100 ( (March) ) 1949. 3. Yorke, A.: Parapsoriasis en Plaques Treated with Vitamin D2 , Brit. J. Dermat. 61:100 ( (March) ) 1949. 4. Goldberg, L. C.: Personal communication to the author. 5. McCarthy, L.: Differential Diagnosis of Parapsoriasis , Arch. Dermat. & Syph. 45:81 ( (Jan.) ) 1942. 6. Gross, P.: Pityriasis Lichenoides et Varioliformis Acuta (A Variety of Parapsoriasis) , Arch. Dermat. & Syph. 23:33 ( (Jan.) ) 1931. 7. Pierard, J.: Sur une forme atypique de parapsoriasis en gouttes: Rapports du parapsoriasis en gouttes et de la parakeratosis variegata , Arch. belges dermat. et syph. 3:198 ( (Feb.) ) 1947. 8. Weidman, F. D., in discussion on McCarthy.5 9. Dwinelle, H.: Personal communication to the author. 10. Montgomery, H., and Burkhart, R. J.: Parapsoriasis: Its Relation to Mycosis Fungoides and Tuberculosis; A Review of 52 Cases , Arch. Dermat. & Syph. 46:673 ( (Nov.) ) 1942. 11. Ormsby, O. S., and Montgomery, H.: Diseases of the Skin , Ed. 7, Philadelphia, Lea & Febiger, 1948, p. 326. 12. Civatte, A.: Note pour servir à l'etude des tuberculides papulosquameuses: trois cas de tuberculides a forme de parapsoriasis , Ann. dermat. et syph. 37:209, 1906. 13. Civatte, A.: Les parapsoriasis , in Darier, J.; Sabouraud, R.; Gougerot, H.; Milian, G.; Pautrier, L. M.; Ravaut, P.; Sézary, A., and Simon, C.: Nouvelle pratique dermatologique , Paris, Masson & Cie, 1936, Vol. 7, p. 686. 14. Combes, F. C.: Personal communication to the author. 15. Ravaut, P.: Cited by Civatte.13 16. Milian, G., and Pinard, M.: Parapsoriasis en gouttes, sa nature tuberculeuse , Ann. dermat. et syph. 38:477, 1907. 17. Andrews, G. C.: Diseases of the Skin , Philadelphia, W. B. Saunders Company, 1939, p. 216. 18. Juliusberg, F.: Die Parapsoriasis , in Handbuch der Haut- und Geschlechtskrankheiten , edited by J. Jadassohn, Berlin, Springer-Verlag, 1928, Vol. 7, Pt. (1) , p. 288. 19. Michelson, H. E.: Calciferol in the Treatment of Cutaneous Tuberculosis , Arch. Dermat. & Syph. 58:680 ( (Dec.) ) 1948. 20. Stokstad, E. L. P., and Jukes, T. H.: Water Soluble Vitamins , Ann. Rev. Biochem. 18:435, 1949. 21. Dowling, G. B.: Vitamin D in the Treatment of Cutaneous Tuberculosis , Brit. J. Dermat. 60:127 ( (April) ) 1948. 22. Weld, C. B.: A Capillary Resistance Test and Its Relation to Vitamins C and D , J. Pediat. 9:226, 1936. 23. Pascher, F.; Silverberg, M. G.; Marks, I. E., and Markel, J.: Therapeutic Essays of the New York Skin and Cancer Unit, Post Graduate Medical School, New York University, Bellevue Medical Center: Essay II: Calciferol (D2) , J. Invest. Dermat. 13:89, 1949. 24. Reed, C. I.; Struck, H. C., and Steck, I. E.: Vitamin D: Chemistry, Physiology, Pharmacology, Pathology, Experimental and Clinical Investigations , Chicago, University of Chicago Press, 1939, p. 207.

WEBSTER, JAMES R.;FALK, ALFRED B.

1952 A.M.A. Archives of Dermatology & Syphilology

doi: 10.1001/archderm.1952.01530250049005

Abstract IT IS NOW generally agreed that some disturbance of vitamin A metabolism is important in the causation of pityriasis rubra pilaris.1 However, knowledge concerning the absorption, conversion, transport, storage, and utilization of this dietary factor is still far from complete, and very little is known of how or why this mechanism is interfered with in patients with pityriasis rubra pilaris. Two varieties of the disease may be distinguished: first, that in which there are definite indications of vitamin A deficiency, resulting from deficient intake, abnormal demand, or a gross fault in absorption, and which is readily improved by vitamin A therapy, and, second, that in which such gross deficiency cannot be demonstrated and which shows only slow response to ingestion of massive doses of the vitamin over a considerable time. In general, the first variety usually appears for the first time in adult life, while the latter References 1. Ormsby, O. S., and Montgomery, H.: Diseases of the Skin , Ed. 7, Philadelphia, Lea & Febiger, 1948, pp. 342-343. 2. Sutton, R. L., and Sutton, R. L., Jr.: Handbook of Diseases of the Skin , St. Louis, C. V. Mosby Company, 1949, p. 439. 3. Brunsting, L. A., and Sheard, C.: Dark Adaptation in Pityriasis Rubra Pilaris , Arch. Dermat. & Syph. 43:42 ( (Jan.) ) 1941. 4. Leitner, Z. A., and Ford, E. B.: Vitamin A and Pityriasis Rubra Pilaris , Brit. J. Dermat. 59:407, 1947. 5. Porter, A. D., and Godding, E. W.: Pityriasis Rubra Pilaris and Vitamin A , Vitamin A and Pityriasis Rubra Pilaris 57:197, 1945. 6. Weiner, A. L., and Levin, A. A.: Pityriasis Rubra Pilaris of Familial Type: Experiences in Therapy with Carotene and Vitamin A , Arch. Dermat. & Syph. 48:288 ( (Sept.) ) 1943. 7. Jeghers, H.: Skin Changes of Nutritional Origin , New England J. Med. 228:714, 1943. 8. This name was suggested by Dr. M. B. Sulzberger in discussion on Brunsting and Sheard.1e 9. Cornbleet, T., and Cohen, D.: A Case for Diagnosis (Pityriasis Rubra Pilaris?) , Arch. Dermat. & Syph. 47:463 ( (March) ) 1943. 10. Spector, S.; McKhann, C. F., and Meserve, E. R.: Effects of Disease on Nutrition , Am. J. Dis. Child. 66:376 ( (Oct.) ) 1943. 11. Gross, P.: Pityriasis Rubra Pilaris and Vitamin Therapy , Arch. Dermat. & Syph. 44:270 ( (Aug.) ) 1941. 12. Hickman, K. C. D.; Harris, P. L., and Woodside, M. R.: Interrelationship of Vitamins A and E , Nature, London 150:91, 1942. 13. Ruch, D. M.; Brunsting, L. A., and Osterberg, A. E.: Use of Vitamin A Tolerance Test in Certain Cases of Dermatologic Disorders , Proc. Staff Meet., Mayo Clin. 21:209, 1946. 14. Cornbleet, T., and Popper, H.: Properties of Human Skin as Revealed by Fluorescence Microscopy: The Normal Skin; The Vitamin A Content of the Skin , Arch. Dermat. & Syph. 46:59 ( (Jan.) ) 1942. 15. Wright, C. S., and Niedleman, M. L.: Pityriasis Rubra Pilaris (Acute Type) Responding to Vitamin A Therapy , Urol. & Cutan. Rev. 51:684, 1947. 16. Goodman, H.: Dermatologic Symptoms of Vitamin Deficiencies , Arch. Dermat. & Syph. 38:389 ( (Sept.) ) 1938. 17. The corticotropin was of bovine origin and was supplied by The Armour Laboratories, Chicago 9. 18. Clausen, S. W., and McCoord, A. B.: The Carotenoids and Vitamin A of the Blood , J. Pediat. 13:635, 1938. 19. May, C. D.; Blackfan, K. D.; McCreary, J. F., and Allen, F. H., Jr.: Clinical Studies of Vitamin A in Infants and in Children , Am. J. Dis. Child. 59:1167 ( (June) ) 1940. 20. This is equivalent to approximately 6,000 U. S. P. units of vitamin A per pound (0.5 kg.) of body weight. 21. Castor, C. W., and Baker, B. L.: Local Action of Adrenocortical Steroids on Epidermis and Connective Tissue of Skin , Endocrinology 47:234, 1950.

CARO, MARCUS R.;SENEAR, FRANCIS E.

1952 A.M.A. Archives of Dermatology & Syphilology

doi: 10.1001/archderm.1952.01530250065006

Abstract CUTANEOUS nodules are seen frequently in patients suffering from diseases of the joints. In most instances they occur as nodules of rheumatoid arthritis. Less often they are associated with rheumatic fever or gout. The nodular dermatosis that we are reporting bears a gross resemblance to the cutaneous lesions of the above diseases. Histopathologic examination shows that these nodules are unique, however, in being composed of masses of bizarre multinucleated giant cells. This dermatosis either is rare or has rarely been reported in the past, and the identity of the pathognomonic cells has been variously interpreted in the few cases that have been observed. Allen1 studied sections from two cases, and he considered the nodules to be reticulohistiocytomas. In Allington's case2 the diagnoses of gangliioneuroma, histiocytoma, and myoblastoma were considered. Zak3 reported four cases as reticulohistiocytomas of the skin. In 1932 we prepared and studied sections from multiple lesions of a patient of Dr. References 1. Allen, A. C.: Survey of Pathologic Studies of Cutaneous Diseases During World War II , Arch. Dermat. & Syph. 57:19 ( (Jan.) ) 1948. 2. Allington, H. V.: A Case for Diagnosis (Ganglioneuroma? Histiocytoma? Myoblastoma?) , Arch. Dermat. & Syph. 62:452 ( (Sept.) ) 1950. 3. Zak, F. G.: Reticulohistiocytoma (``Ganglioneuroma'') of the Skin , Brit. J. Dermat. 62:351 ( (Sept.) ) 1950. 4. Montgomery, H., and O'Leary, P. A.: Multiple Ganglioneuromas of the Skin , Arch. Dermat. & Syph. 29:26 ( (Jan.) ) 1934. 5. Bennett, G. A.; Zeller, J. W., and Bauer, W.: Subcutaneous Nodules of Rheumatoid Arthritis and Rheumatic Fever , Arch. Path. 30:70 ( (July) ) 1940.

SCHOCH, ARTHUR G.

1952 A.M.A. Archives of Dermatology & Syphilology

doi: 10.1001/archderm.1952.01530250078007

Abstract SOME will accept, some reject the following ideas, but most persons will reflect upon them and give them further thought. That is enough. During the last seven years much literature has accumulated on the treatment of early syphilis with penicillin. Generally speaking, the total dosage of penicillin has varied from a minimum of 300,000 units to a maximum of 10,000,000 units per patient. Published cumulative failure rates have varied from a minimum of 4 or 5% to a maximum of 50%. Practically all published data on failure rates have included cures listed as failures. Much stress has been placed by noted authorities on an intrinsic over-all failure rate of about 20% in the treatment of early syphilis with penicillin. With this conclusion, I am in complete disagreement, I contend that the failure rate is entirely too high. The purpose of this paper is to point out that the References 1. Schoch, A. G., and Alexander, L. J.: Reinfection and Relapse After Treatment of Early Syphilis with Penicillin , Arch. Dermat. & Syph. 60:683-700 ( (Nov.) ) 1949. 2. Magnuson, H. J., and Rosenau, B. J.: The Rate of Development and Degree of Acquired Immunity in Experimental Syphilis , Am. J. Syph. 32:418-436 ( (Sept.) ) 1948. 3. Schoch, A. G., and Alexander, L. J.: Reinfection in Syphilis , Am. J. Syph. 27:15-29 ( (Jan.) ) 1943. 4. Rein, C. R.: Problèmes relatifs au sero-diagnostic de la syphilis, in Colloque International sur la Syphilis, Organization Mondiale de la Sante, Paris, Sept. 25-Oct. 7, 1950 , Prophylax. antivén 22:500-512 ( (Nov.) ) 1950 5. Serodiagnosis of Syphilis: Recent Advances , J. Michigan M. Soc. 46:541-549 ( (May) ) 1947 6. The Serologic Tests in Penicillin-Treated Syphilis , New York J. Med. 47:2450-2452 ( (Nov. 15) ) 1947. 7. Rein, C. R., and Kostant, G. H.: Lupus Erythematosus: Serologic and Chemical Aspects , Arch. Dermat. & Syph. 61:898-903 ( (June) ) 1950. 8. Chargin, L., and Rein, C. R.: The Reliability of Serologic Tests for Syphilis , J. Mt. Sinai Hosp. 12:111-115 ( (May) -June) 1945. 9. Barnard, R. D.; Rein, C. R., and Doan, C. A.: False Positive Serologic Tests for Syphilis Following Blood Donation , Am. J. Syph. 30:255-263 ( (May) ) 1946. 10. Scott, V.; Rein, C. R.; Schamberg, I. L.; Moore, J. E., and Eagle, H.: The Serologic Differentiation of Syphillis and False Positive Sera , False Positive Serologic Tests for Syphilis Following Blood Donation 29:505-528 ( (Sept.) ) 1945. 11. Rein, C. R., and Elsberg, E. S.: False Positive Serologic Reactions for Syphilis with Special Reference to Those Due to Smallpox Vaccinations (Vaccinia) , The Serologic Differentiation of Syphillis and False Positive Sera 29:303-312 ( (May) ) 1945 12. Studies on the Incidence and Nature of False Positive Serologic Reactions for Syphilis , Am. J. Clin. Path. 14:461-469 ( (Sept.) ) 1944. 13. Schoch, A. G., and Alexander, L. J.: Unusual Behavior of Syphilitic Reagin Following Intensive Treatment of Early Syphilis , Am. J. Syph. 28:305-309 ( (May) ) 1944. 14. Nelson, R. A., Jr., and Mayer, H. E.: Immobilization of Treponema Pallidum in Vitro by Antibody Produced in Syphilitic Infection , J. Exper. Med. 89:369-393 ( (April) ) 1949 15. Nelson, R. A., Jr.; Zheutlin, H. E. C.; Diesendruck, J. A., and Austin, P. G. M., Jr.: Studies on Treponemal Immobilizing Antibodies in Syphilis , Am. J. Syph. 34:101-121 ( (March) ) 1950. 16. O'Leary, P. A.: Five-Year Follow-Up Study of Early Syphilis, From Patients Treated at the Chicago Intensive Treatment Center , read at the Ninth Annual Meeting of the American Academy of Dermatology & Syphilology, Chicago , (Dec. 2) -7, 1950. 17. Padgett, P.: Personal communication to the author. 18. Stokes, J. H.; Beerman, H., and Ingraham, N. P.: Modern Clinical Syphilology , Ed. 3, Philadelphia, W. B. Saunders Company, 1944. 19. Moore, J. E.: Modern Treatment of Syphilis , Ed. 2, Springfield, Ill., Charles C Thomas, Publisher, 1943. 20. Smith, D. C.: Personal communication to the author. 21. Kierland, R. R.; Herrell, W. E., and O'Leary, P. A.: Treatment of Syphilis with Aureomycin Administered by Mouth , Arch. Dermat. & Syph. 61:185-195 ( (Feb.) ) 1950. 22. Schoch, A. G., and Alexander, L. J.: Terramycin in the Control of Venereal Diseases , Ann. New York Acad. Sc. 53:459-460 ( (Sept. 15) ) 1950.

GOLDBERG, H. C.

1952 A.M.A. Archives of Dermatology & Syphilology

doi: 10.1001/archderm.1952.01530250087008

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract A variety of needles are available for the removal of superfluous hair. The long, stiff needles in common use among dermatologists are not the best for this purpose. Lay electrologists in general prefer a platinum-iridium needle which is adapted for gentle insertion into the hair follicle. This needle has an extremely narrow diameter of about 0.005 in. (0.013 cm.). It is flexible but can be pushed easily through a tight hair follicle. Yet it is soft enough to buckle when pushed into the skin near, but not into, the follicular opening. It is shorter than most other types of needles, measuring about 0.25 in. (0.64 cm.), but this is amply long for any hair follicle. Better control and accuracy and ease of penetration are obtained with these needle qualities. This type of needle is of equal value for use in the short-wave spark-gap and the galvanic-current machines. Scarring of the

MUSKATBLIT, EMANUEL;FISHER, DOROTHY;Karpluk, F. E.

1952 A.M.A. Archives of Dermatology & Syphilology

doi: 10.1001/archderm.1952.01530250087009

Abstract Trichophyton faviforme, known since 1893, has rarely been isolated in the United States. In 1947, Fowle and Georg1 reported 23 cases of suppurative ringworm contracted from cattle. These cases occurred in a farming community in central Pennsylvania. Cultural studies showed that 14 of these cases were caused by T. faviforme, and 4, by Trichophyton mentagrophytes. In the remaining five cases microscopic examination and cultures gave negative results, but the diagnosis of T. faviforme infection was made from the nature of the lesions and the history of contact with ringworm-infected cattle. In 1949 Carney2 reported 17 cases of T. faviforme infection occurring in Iowa farming areas. In most of the cases reported by Fowle and Georg, local treatment of the lesions proved of little value. They gave iodides intravenously and by mouth. Carney, however, stated that administration of mild fungicides and manual epilation were adequate. The following cases References 1. Fowle, L. P., and Georg, L. K.: Suppurative Ringworm Contracted from Cattle , Arch. Dermat. & Syph. 56:780-793 ( (Dec) ) 1947. 2. Carney, R. G.: Inflammatory Ringworm Due to Trichophyton Faviforme , Arch. Dermat. & Syph. 59:209-216 ( (Feb.) ) 1949.

BRAITMAN, MAX

1952 A.M.A. Archives of Dermatology & Syphilology

doi: 10.1001/archderm.1952.01530250091010

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract Vulvar pruritus is a frequent complaint. The cause is difficult to discern, and the condition is complicated by reactions to medicaments used. With persistent and intelligent questioning, the so-called essential pruritus may be attributed to an original sensitizing agent, be it douching solution, nail polish, or, as in this case, colored toilet tissue. REPORT OF A CASE A 25-year-old white woman complained of vulvar itching of four weeks' duration. The condition had become progressively worse, being aggravated by apparently the most innocuous topical remedies. Itching and burning were intense. On examination severe edema, oozing, and marked redness of the vulvar and pubic areas were observed. Initial questioning failed to reveal any suggestive causal factor. Routine medication was followed by some relief, but the condition failed to clear, although there were periods of improvement and recurrence. After two months, it was suggested that the use of toilet tissue be stopped

RILEY, KATHLEEN A.

1952 A.M.A. Archives of Dermatology & Syphilology

doi: 10.1001/archderm.1952.01530250091011

Abstract Since the first report on penicillin-sensitivity reactions by Keefer1 in 1943, there have been many subsequent reports. Brown,2 in 1948, reviewed the literature of 308 reports from 1943 to 1948. Beerman,3 in 1949, summarized the status of penicillin-sensitivity reactions and stated that one of the most frequently reported clinical pictures is that of a serum-sickness-like reaction. The first systematic study of the clinical and immunological phenomenon of serum sickness was done by von Pirquet and Schick4 and was reported in 1905. Cecil5 defines serum sickness as "allergic reaction resulting from the parenteral administration of a foreign serum and characterized by an incubation period, skin eruption, enlargement of lymph nodes, fever, edema and polyarthritis.'' A similar syndrome has been reported as a result of the sulfonamides.6 With the use of antibiotics, syndromes resembling serum sickness have been seen frequently resulting from penicillin. This syndrome has References 1. Keefer, C. S.; Blake, F. G.; Marshall, E. K., Jr.; Lockwood, S., Jr., and Wood, W. B., Jr.: Penicillin in the Treatment of Infections (500 Cases) , J. A. M. A. 122:1217-1224 ( (Aug. 18) ) 1943.Crossref 2. Brown, E. A.: Reactions to Penicillin , Ann. Allergy 6:723-746, 1948. 3. Beerman, H.: Drug Eruptions: A Survey of Recent Literature , Am. J. M. Sc. 218:446, 1949.Crossref 4. von Pirquet, C. F., and Schick, B.: Die Serum Krankheit , Leipzig, F. Deuticke, 1905. 5. Cecil, R. L.: Textbook of Medicine , Philadelphia, W. B. Saunders Company, 1951. 6. Longscope, W. T.: Serum Sickness and Analogous Reactions from Certain Drugs, Particularly the Sulfonamides , Medicine 22:251, 1943. 7. Zussman, B. M.: Severe Serum Sickness Type of Penicillin Reaction: Failure of Antihistamine Therapy , Ann. Allergy 8:751-753, 1950. 8. Hansel, F. K.: Penicillin Sensitivity , Ann. Allergy 7:619 and 624, 1949.

CANIZARES, ORLANDO

1952 A.M.A. Archives of Dermatology & Syphilology

doi: 10.1001/archderm.1952.01530250094012

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract Recently, plastic or polyethylene bottles have been widely used by cosmetic manufacturers and pharmaceutical companies. They have the advantage of being unbreakable and light in weight. The ``spray-type'' bottle gives a fine, vaporized or jet application, depending upon the position in which it is held and the consistency of the substance used. On certain occasions in dermatological practice, it may be advantageous to use this type of packaging. This is particularly desirable in the case of the discriminating patient. The usual watery solutions may be easily applied with the spray-type bottle. It delivers a fine mist which may be directed toward the desired area. This simplifies the application, for no cotton or gauze is needed. Shake lotions may also be applied with the spray-type container, but instead of a fine mist a direct jet is obtained, which may be directed toward the affected area. The application of this type of

Mendelsohn, H. Victor

1952 A.M.A. Archives of Dermatology & Syphilology

doi: 10.1001/archderm.1952.01530250095013

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract To the Editor:—In the August, 1951, issue of the Archives, there is a report by McCulloch and Zeligman of a case of fixed drug eruption and an extracutaneous effect, an epididymitis, due to the ingestion of antipyrine (64:198). The authors state that they were unable to find in the literature any reports of fixed extracutaneous effects from drugs, other than those reported by J. Jadassohn and by Haber, which they cite. To my knowledge a few similar reports exist in the literature. I have reported a case of fixed eruption with an extracutaneous effect due to oxophenarsine hydrochloride (mapharsen®). The eruption, which was of the erythematous type, appeared on both palms and in the left toe 5 to 10 minutes after an injection and disappeared within three days, leaving no pigmentation. The extracutaneous effect consisted of severe, sharp pain in the upper jaw that appeared 10 to

Rothman, Stephen;Webster, James R.

1952 A.M.A. Archives of Dermatology & Syphilology

doi: 10.1001/archderm.1952.01530250096014

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract Panniculitis (Weber-Christian Disease?). Presented by Dr. James H. Mitchell and (by invitation) Dr. Heyworth Sanford. G. W., an 8½-month-old child, was admitted to Presbyterian Hospital on April 9, 1951, with the presenting complaints of "skin eruption and intermittent fever of 100 to 102 F." for two and a half months. The first lesions were noted by the parent on the lower abdomen. These were described as being the size of a quarter and gave the skin involved the appearance of light red in the center and purple toward the periphery. Since that time these lesions have appeared on other parts of the body in the following sequence: flank, upper chest, lower back, chin, right thigh, legs, and elbows. The general picture of the patient has become one of lethargy and irritability, with intermittent temperature elevation, as high as 104 F. Various forms of treatment have been employed, which to

Bechet, Paul E.;Rosen, Isadore;Lewis, George M.

1952 A.M.A. Archives of Dermatology & Syphilology

doi: 10.1001/archderm.1952.01530250116015

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract Localized Atopic Eczema (Commissures). Presented by Dr. George M. Lewis. F. K., a woman aged 36, noticed a small fissure in the left corner of the mouth five years ago. Two or three years ago the right corner fissured. Both fissures have been persistent, pruritic, and tender at times and limit the opening of the mouth. There has been some improvement in the summer, but recently the condition has become worse. She has been given two x-ray treatments, two radium treatments, and several courses of therapy with vitamins B and C, without effect. Redness and superficial fissuring extend 3 mm. from both corners of the mouth. There is a thin, irregular, white film over the left buccal mucous membrane. The right mucous membrane shows some whiteness in lines adjacent to the biting edge. A mycologic examination gave negative results. Treatment was started with administration of antihistaminic drugs by mouth

1952 A.M.A. Archives of Dermatology & Syphilology

doi: 10.1001/archderm.1952.01530250120017

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract In the article by Dr. Flesh and Dr. Hunt entitled "Local Depilatory Action of Some Unsaturated Compounds," published in the March, 1952, issue of the A. M. A. Archives, page 261, the legend now under Figure 5 belongs under Figure 6 and that under Figure 6 belongs under Figure 5.

1952 A.M.A. Archives of Dermatology & Syphilology

doi: 10.1001/archderm.1952.01530250120016

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract ANNOUNCEMENTS Affiliation Between the Skin and Cancer Hospital of Philadelphia and the Graduate School of Medicine of the University of Pennsylvania.—Dr. Bertram Shaffer, Medical Director of The Skin and Cancer Hospital of Philadelphia, has announced the establishment of a medical affiliation between the Skin and Cancer Hospital and the Graduate School of Medicine of the University of Pennsylvania. The Skin and Cancer Hospital will retain its corporative identity, but the Graduate School of Medicine has agreed to be responsible for the professional and educational standards of the institution. A new Medical Board has been created which will act also as the Executive Committee of the Medical Staff. This consists of six chiefs of service with the title of Attending Dermatologists, namely: Dr. Donald M. Pillsbury, Dr. Carroll S. Wright, Dr. H. E. Twining, Dr. Reuben Friedman, Dr. H. M. Samitz, and Dr. Edward Ozellers. The Medical Board includes